Photo by Andy Miah via Flickr.

How mHealth has failed to revolutionize China’s healthcare

The first time I realized how different the Chinese healthcare system was from those in the West was a couple of years ago when I started to feel terribly fatigued. I went to my local hospital and realized I would have to self-diagnose. There was no general practice doctor available, so I stood in front of the information board listed with the various medical specializations with a huge question mark above my head. After all, fatigue can be a symptom of the common cold as well as the bubonic plague. In the end, I decided that the culprit was probably Beijing’s smog and went to see a pulmonologist. I was wrong.

My experience gave me a short glimpse of the frustrations that patients in China feel when they try to get medical treatment. There is a large gap between the availability and the differences in quality of urban and rural medical centers. This is why patients from all over the country flock to the best clinics in urban centers. The lack of trained clinicians often means that doctors will spend only a few minutes with each patient leaving them with an insufficient understanding of their ailments.

Self-diagnosis: an illustration. (Photo from Pixabay)

After my misdiagnosis, it was only several months later till I received proper treatment for my illness. For me, it ended up being a common hormonal imbalance. But for others, the inaccessibility of quality healthcare is a serious issue. This was why healthcare apps were welcomed with such fanfare as a revolutionary solution for China’s healthcare system.

The math seems simple. More than half of the Chinese population, which works out to be about 731 million people, use the Internet. Of this 731 million people, 95 percent are mobile internet users, according to a 2016 CNNIC report. China’s healthcare expenditure is growing fast, while its citizens are more willing to spend more on quality medical service. This prompted many leading companies such as Baidu, Tencent, Alibaba, and Ping An Insurance, to invest billions of dollars in mHealth, an industry which uses mobile phones and wireless technology in medical care. And boom it did — China now has hundreds of healthcare apps. The only problem is many of them fail to bring the desired profit to their developers.

Regulators have been cautious with the new services. Online diagnosis is still in a legal gray area in China, which is why the actual service is limited to general medical inquiries. Online distribution of pharmaceuticals was also crippled by regulation changes, likely because it represents direct competition to state hospitals.

China’s state healthcare system, the main provider of healthcare services, has been slow to incorporate mHealth solutions even though the Chinese government has promised to better adopt internet technology. China still doesn’t have a unique patient database which makes it hard to develop wider solutions.

All of this has prompted the big players to look for different ways of securing gains. Baidu has decided to shift its main focus from online-to-offline doctor appointments to developing an AI bot for doctors and patients. Alibaba has announced that it will explore other areas such as consumer safety.

According to media reports, other health startups which emerged as the winners of the great mHealth game, such as Guahao (We Doctor Group), Chunyu Yisheng, and DXY (DingXiangYuan), are also struggling to create profitable business models. They are looking into other options, such as setting up private hospitals or focusing on health care professionals. Chunyu Yisheng has reported RMB 130 million of revenues in 2015 with profits amounting to RMB 30 million, but for a mobile app with 30 million users this is just a drop in the ocean.

Screenshot from the Chunyu Yisheng app. (Photo by Baidu Images)

Although the mHealth boom has failed to bring the kind of revolution its developers envisioned, these companies are not giving up that easily. But China’s healthcare reform, just as any healthcare reform in the world, is a complicated matter with many social and economic factors that need to be taken into account.

Currently, China is working on training more general practitioners and family doctors who are able to provide quality care by getting to know their patients and spending time on prevention. The real revolution here will not be providing consultations with busy doctors through mobile phones, but enabling affordable and quality care to the millions of poor rural dwellers. And even though the mHealth industry can help to achieve that, sometimes this goal does not go hand in hand with profitability.

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